Case 129:   Metastasis - Neuroendocrine Tumor

Diagnostic Category:

Clinical Presentation:

52 year old woman with pancreatic neuroendocrine tumor.

CT: Hypervascular metastases with desmoplastic components and "sump effect".

Imaging Findings:

CT shows large hypervascular metastasis in the left lobe and smaller ones in segment 4A and 5 with washout on equilibrium phase. There are however fibrotic bands and septae within the large metastasis with typical late enhancement. Coexistence of washout and fibrotic progressive enhancement within the same mass is typical neuroendocrine tumors.

Note the increased perifocal extralesional arterial flow surrounding the metastasis in segment 4A ("sump effect").

Large hypervascular primary tumor of the pancreatic tail displacing the stomach anteriorly (last image).